POUCH,UROSTOMY,PREMIER H#84497 (27799)    VA PRODUCT (50.68)

Name Value
NAME POUCH,UROSTOMY,PREMIER H#84497
VA GENERIC NAME POUCH,UROSTOMY
DOSAGE FORM POUCH
NATIONAL FORMULARY NAME POUCH,UROSTOMY POUCH
CREATE DEFAULT POSSIBLE DOSAGE YES
CODING SYSTEM
  • RxNorm
    CODE:
COPAY TIER
  • COPAY TIER LEVEL:   0
    COPAY EFFECTIVE DATE:   2017-08-01 00:00:00
PGX ELIGIBLE NO
PGX SUPPRESSED NO
VA PRINT NAME POUCH,UROSTOMY,PREMIER H#84497
VA PRODUCT IDENTIFIER XI989
TRANSMIT TO CMOP YES
VA DISPENSE UNIT EA
MASTER ENTRY FOR VUID YES
VUID 4036757
EFFECTIVE DATE/TIME
  • 2017-06-23 00:00:00
    STATUS:   ACTIVE